急性脑梗死患者外周血Th17、Treg、Th17/Treg及炎症因子的动态变化过程研究

目的探讨急性脑梗死(AIS)患者外周血Th17、Treg、Th17/Treg及相关炎症因子的表达及其动态演变过程。方法选取32例AIS患者为实验组及32名健康人为对照组。分别检测AIS患者第1 d、4 d、7 d,外周血中Th17及Treg占CD4+T细胞比例及Th17/Treg比值,并检测白介素6(IL-6)、中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)和红细胞沉降率(ESR),分析其在AIS后的变化规律。结果AIS组于起病后第1 d、4 d,外周血Th17、Treg比例分别与对照组相比,差异有统计学意义(均P<0.05);AIS患者第7 d Th17、Treg比例逐渐恢复,与对照组比较差异无统计学意义(均P>0.05);AIS患者Th17/Treg比值在第1 d、4 d、7 d逐渐减小,但始终明显高于对照组(均P<0.05)。在AIS后的第1 d、4 d、7 d,IL-6、NLR及CRP分别均明显高于对照组(均P<0.05);AIS患者ESR第1 d与对照组比较无统计学意义(P>0.05),第4 d、7 d明显高于对照组(均P<0.05)。AIS患者外周血Th17比例及Th17/Treg、NLR、CRP、ESR分别与IL-6呈正相关(ρ=0.298,P=0.007;ρ=0.351,P=0.001;ρ=0.377,P=0.001;ρ=0.582,P=0.000;ρ=0.388,P=0.000);Treg比例与IL-6呈负相关(ρ=-0.242,P=0.029)。结论AIS患者早期存在Th17/Treg失衡,且合并有全身炎症反应。

Dynamic variation of peripheral Th17,Treg,Th17/Treg and inflammatory biomarkers in patient with acute ischemic stroke

Objective To investigate dynamic variation of peripheral blood Th17,Treg and Th17/Treg in patient with acute ischemic stroke(AIS),and level of inflammatory biomarkers including neutrophil to lymphocyte ratio(NLR),IL-6,CRP and ESR.Methods Thirty-two patients with AIS and 32 healthy controls were enrolled.The levels of peripheral blood Th17 and Treg in patient with AIS were detected by flow cytometry at 1 d,4 d and 7 d after admission,and then compared with healthy controls.At the same time,those relevant inflammatory biomarkers were also examined and analyzed.Results Compared with control group,the proportion of Th17 and Treg cells were evidently different on patients 1 d and 4 d after stroke(all P<0.05).Then,those cells gradually recovered at 7 d after stroke,with no statistical significance compared with controls(all P>0.05).However,there were consistently significant differences in elevated ratio of Th17/Treg,and high level of IL-6,NLR and CRP from 1 d to 7 d after stroke in comparation with controls(all P<0.05).The ESR in patients with AIS had significant differences compared with controls at 4 d and 7 d(all P<0.05),except 1 d after admission(P>0.05).The proportion of Th17(ρ=0.298,P=0.007)and Treg(ρ=-0.242,P=0.029),Th17/Treg(ρ=0.351,P=0.001),NLR(ρ=0.377,P=0.001),CRP(ρ=0.582,P=0.000),ESR(ρ=0.388,P=0.000)all showed significant correlations with IL-6.Conclusion There may be imbalance of Th17/Treg and systemic inflammatory response in patients with AIS.